I have a pt who was finally dx with focal epilepsy. Prior to dx she was on Cymbalta 30 for psoriatic arthritis and fibromylagia. Tapered her cymbalta for increased seizure risk and because she didnt say it was helping pain. Placed on zoloft 25 to start never advanced. Flare ups came back rheumatologist said continue cymbalta. Discontinued zoloft. Started mirtzapine 7.5 for anxiety and depression start then to 15. Pt never discontinued zoloft i did not know. Neuro though remeron was increasing seizures. Pcp though possible seratonin syndrome. Pcp wants to taper off both 25 of zoloft and remeron 15. Encouraged to half doses for 1-2 weeks and then take every other day until discontinued. Pt now reports extreme irritability, flu like symptoms and anger. Help